Outdoor Columnists

Medicaid expansion could cost Colorado $858 million over 10 years

FILE -- Dr. James J. Meyer, M.D. checks over patient Ashley during her visit Sept. 11, 2012. (She did not want her last name used or that of her daughter.) Medicaid is her secondary not her primary form of insurance (Helen H. Richardson, The Denver Post)

The state's share of costs for expanding Medicaid rolls under federal health-care reform could be $858 million over 10 years, according to new estimates from the Kaiser Family Foundation.

The analysts still consider the price a bargain for Colorado and other states that want to bring health insurance to hundreds of thousands of low-income residents. The federal government will pay 100 percent of the added price in the first few years, and bringing people under Medicaid will slow cost-shifting to private insurance and public clinics, they said.

"It's hard to conclude anything other than that it's pretty attractive and should be hard for states ... to walk away from," said John Holahan, director of the health-policy research center at the Urban Institute and a co-author of the review.

Colorado Medicaid officials have not released their own estimates, and the governor's office has declined to commit to the key building block of expanding health insurance, saying it needs to hear more program details from federal officials. Kaiser is the only group to step forward with detailed figures, and the nonpartisan foundation bases its estimates on existing state programs, national and local tallies of the uninsured, and state spending summaries.

The federal share of insuring 225,000 new Medicaid patients in Colorado would be about $10.3 billion over the next 10 years, the report said.

Colorado's costs, $858 million, could be offset by less need for state payments to hospitals that care for the poor. Kaiser said those savings could cut Colorado's share of Medicaid expansion by another $277 million, to $581 million.

Advertisement

Given that Colorado is already expected to spend $30.3 billion of its own money on Medicaid over the 10 years, the expansion would add 1.9 percent to the state budget, the report said.

Kaiser officials said they understood the big numbers can create "sticker shock" in such a widely used government program. But they added that the main message of the report is that states can make a large dent in the uninsured for relatively small amounts of their own money, if they join the expansion.

"Still, even 1 percent of general-fund spending is large, when states still haven't fully recovered (from the deep recession)," said Alan Weil, executive director of the National Academy for State Health Policy, one of the participants in the Kaiser study announcement.

States that have talked openly of declining the expansion will face Medicaid cost increases anyway, Kaiser said. Medicaid rolls are expanding already under existing rules.

Expansion has always been a basic tenet of the controversial health-care-reform law passed in 2010. The U.S. Supreme Court appeared to make states' participation in Medicaid growth optional, even as it upheld the rest of the law.

Democrats and advocacy groups have called for Colorado to embrace the expansion. Gov. John Hickenlooper and his staff have said they await rules and better budget estimates before committing. State officials on Monday said they would review the Kaiser report.

More detailed research should boost arguments for expansion, said Bob Semro, health analyst for Denver's Bell Policy Center. The uninsured cost the state in unpaid emergency- room visits and expensive chronic illnesses.

"As regular citizens, we are paying for these uninsured people and doing it through a backdoor way," Semro said.

Clubs keeping eye on RPI rankingsIn the age of RPI (Ratings Percentage Index) determining playoff seeding in Colorado prep sports, playing a championship schedule has become more important than ever for any team expecting to compete for a state title. Full Story

The Boulder alt-country band gives its EPs names such as Death and Resurrection, and its songs bear the mark of hard truths and sin. But the punk energy behind the playing, and the sense that it's all in good fun, make it OK to dance to a song like "Death." Full Story